Key result
S-ICD implantation proves feasible alongside a pre-existing LBBAP system without device interaction.
Case Report (n=1)
S-ICD implantation is feasible in patients with pre-existing LBBAP, but requires careful intraoperative interaction testing and a preference for bipolar pacing to avoid crosstalk and potentially fatal VF underdetection.
Case of complex HFrEF with bradycardic AF and VF history underscores individualized decisions; leaves open optimal device strategies.
We present the case of a 72-year-old man with chronic heart failure with reduced ejection fraction (left ventricular ejection fraction of 30%), ischemic cardiomyopathy, permanent atrial fibrillation, profound bradycardia (<30 bpm), and a history of ventricular fibrillation (VF).
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A 2026 study conducted a case report in Chronic heart failure with reduced ejection fraction and history of ventricular fibrillation (n=1). Subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation following left bundle branch area pacing (LBBAP) was evaluated on Defibrillation efficacy and appropriate sensing without device-device interaction. Subcutaneous implantable cardioverter-defibrillator implantation was successfully performed in a patient with a pre-existing left bundle branch area pacing system after systematic interaction testing.
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